| NPI | 1912989385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G62252) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G62252) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2010-12-29 |